Elderly people, ‘completed lives’, and ‘assisted dying’

The back cover text of Els van Wijngaarden’s dissertation Ready to give up on life goes as follows. Older people who consider their lives to be ‘completed’, who suffer from the prospect of having to live on and therefore prefer a self-chosen death: it’s not a new issue. What is relatively new, though, is the current Dutch debate about whether we should legalize, facilitate and institutionalize assisted dying in such cases.

Should older people who come to a well-considered conclusion that life is over have the right to assisted dying? In order to develop a careful and morally responsible policy, it is a prerequisite to first gain deeper understanding of this phenomenon. Remarkably very little empirical research has been done into this specific phenomenon of completed life in old age. In fact this thesis is the first empirical study worldwide into the lived experiences of older people who consider their lives to be completed and want to terminate their lives at the self-directed moment, without being severely physically or mentally ill. It addressed essential questions such as: What exactly does it mean that life is considered to be completed? What are the underlying motivations and experiences?

There has been much political and public debate on the question whether elderly people should have a legal right to ask for assisted dying when they consider their life to be completed. (Care)ethicist Frits de Lange contributed to this international discussion on ethicsofcare.org with his paper When is a life completed? Van Wijngaarden wanted to provide insight into what it means when people who are not terminally ill, wish to die, consider their lives to be completed and no longer worth living, or are tired of living. Her qualitative study in which 25 Dutch older citizens participated, aimed at (1) in-depth understanding of a completed life, no longer worth living, (2) an ethical deliberation on the issue of older people and self directed death from a care-ethical reflection on the phenomenon. Her findings show an permanent lived tension, full of ambiguities and ambivalences of an unliveable life, not wanting to die and at the same time a strong consistent wish of assisted dying.

Dissertation: Els van Wijngaarden, Ready to give up on life: A study into the lived experiences of older people who consider their lives to be completed and no longer worth living. Utrecht: University for Humanistic Studies; 2016.

About the author of the dissertation

Els van Wijngaarden (1976) works as a lecture and postdoc researcher at the University for Humanistic Studies and the research institute Tao of Care. Her research concerns the following topics: old age, living with dementia, finitude, death and dying, and death wishes. In 2016, she completed her PhD on the lived experiences of older people who consider their lives to be completed and no longer worth living (funded by The Netherlands Organisation for Scientific Research). Formerly she graduated cum laude in Religious Studies at VU University Amsterdam with specialisation in existential counselling in organisations.

Praemium Erasmianum

On April 10, 2017 it was announced that Els van Wijngaarden is one of the scholars that is awarded a prestigious Dutch academic prize, Praemium Erasmianum. Her doctorate on the experience of people who, not being ill, want to have the right to get assisted suicide has got a lot of coverage, in academia and in society.
The Praemium Erasmianum Foundation is a Dutch cultural institution that covers scholarly work in the humanities, the social sciences and the arts. Its aim is to strengthen the position of the arts, the social sciences and the humanities. It’s aim is to strengthen the position of these domains. The policy of the Foundation is motivated by the ideas of Desiderius Erasmus, from whom it derives its name, and European cultural traditions. Values, such as tolerance, cultural pluralism and critical thinking, are reflected in the choice of the Erasmus Prize laureates.
The Foundation awards this annual prize to individuals or institutions who have made exceptional contributions to culture, society, or social science in Europe and the rest of the world.

Foto Fjodor Buis
During the research process, Van Wijngaarden and her doctoral thesis supervisors (Carlo Leget and Anne Goossensen), published some free available articles on the research topic. The first two listed here are introduced by an abstract on the care of ethics consortium website

(1) E. van Wijngaarden et al.  “Ready to give up on life: The lived experience of elderly people who feel life is completed and no longer worth living”.  / Social Science & Medicine 138 (2015) 257e264. Doi: 10.1016/j.socscimed.2015.05.015

(2) Van Wijngaarden E, Leget C, Goossensen A. . “Caught between intending and doing: older people ideating on a self-chosen death”  BMJ Open 2016; 6:e009895. Doi:10.1136/bmjopen-2015-009895

(3) Van Wijngaarden E, Leget C, Goossensen A. “Till Death Do Us Part: The Lived Experience of an Elderly Couple Who Chose to End Their Lives by Spousal Self-euthanasia”. Gerontologist (2016) 56 (6): 1062-1071.

Some interviews and discussions with Els van Wijngaarden are available at YouTube (in Dutch).

Image at the top is a part of the artwork ‘Takken van het hart’, (brenches of the heart), made by artist Teja van Hoften. Museum Het Depot, the Netherlands.

 

About the author: Webteam

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